PURCHASE AGREEMENT
                                   ORDER FORM

Date:

Customer:
Address:
Phone:	FAX:

_________ITEM DESCRIPTION________________________________UNITS EACH_______PRICE________TOTAL COST

VIBRASOUND® WAVE TABLE...............................................................................___________......... ..$12500.00................$__________

VIBRASOUND® ZERO GRAVITY CHAIR..............................................................___________......... ...$ 3995.00................$__________

VIBRASOUND® MASSAGE TABLE.......................................................................___________.......... ..$ 2995.00................$__________

SENSORIUM™ LSV SENSORY INTERFACE (Temporarily Not Available).......___________........ ......$ 695.00........ .......$__________

ABSOLUTE SCALE OF RELATIVE COSMIC REALITYE.....................................___________........ ......$ 300.00.......... ... .$__________

HARMONIC LAW™: THE SCIENCE OF VIBRATION.........................................___________........ ......$ 150.00......... ..... $__________

PURE WHITE SOUND (68 MINUTES).....................................................................___________.................$ 33.00......... .... .$__________

PURE PINK SOUND (68 MINUTES).........................................................................___________.......... ......$ 33.00.......... ..... $__________

PURE BREATH (68 MINUTES).................................................................................___________..................$ 33.00.............. .$__________

PURE TEARS (68 MINUTES)....................................................................................___________........ .........$ 33.00............... $__________

PURE WIND (68 MINUTES)......................................................................................___________.......... .......$ 33.00................ $__________

PURE ASCENSION (68 MINUTES)..........................................................................___________........... .......$ 33.00............... $__________

PURE DESCENSION (68 MINUTES)........................................................................___________.......... ........$ 33.00.............. .$__________

GDCD SAMPLER (10 MIN ALL ABOVE)...............................................................___________........... .......$ 33.00............... $__________

Transformant™ TRANSFORMED WATER (50 ml)...........................................___________............ ......$ 65.00............... $__________

_

OTHER..........................................................................................................................___________...............________............ $__________

Shipping (Shipping & Tax will be added)................................................................___________.............................................. $__________

Sales Tax.............................................................................................................................................................................................. .$__________

TOTAL SALE (Please make out all checks to InnerSense, Inc)..............................................................................................$__________

Card Number, Expiration Date and 3 Digit Code on Back of Card in Sign Line

Name as shown on card:

Address Associated with card account (if different than above):

Customer here by authorizes InnerSense, Inc. to charge the "Total Sale" amount as indicated on this form. InnerSense, Inc. accepts no

returns on these items. Credit is limited to repair or replacement of damaged merchandise only. Call for return authorizations for

damaged goods. All products are warranted for a period of one year from purchase.

Accepted by (customer signature): _________________________________Date: ______________

Customer: Please fill in, sign, and fax this form to (310) 829-9784 or mail to 2118 Wilshire Blvd. #730, Santa Monica, CA. 90043.